Which of the following patients are at risk for developing drug toxicity? (Select all that apply.)

A) Only administer 40 mg: This option is not appropriate without consulting the healthcare provider. Simply administering a smaller dose without confirming the rationale behind the prescribed 120 mg could result in inadequate treatment for the patient.

B) Use at least two patient identifiers whenever administering a medication: Utilizing two patient identifiers (such as name and date of birth) is essential to ensure that the medication is administered to the correct patient. This step is a key practice in medication safety to prevent errors.

C) Read labels at least two times to make sure it is the correct medication: Carefully reading labels at least twice helps confirm that the nurse is administering the correct medication and dosage. This practice reduces the risk of errors and ensures that the right drug is given.

D) Double-check all calculations: Verifying calculations is critical, especially when dealing with high doses or unusual orders. This step ensures accuracy in the dosage administered and helps prevent medication errors that could lead to toxicity or ineffective treatment.

E) Question unusually large or small doses: It is essential to question any dosage that appears significantly outside the usual range, such as the prescribed 120 mg of Lasix, which exceeds the standard dosing guidelines. Consulting with the healthcare provider for clarification is crucial in such cases to ensure patient safety.

A. The right patient: Identifying the correct patient is crucial to prevent medication errors. This typically involves using at least two identifiers, such as the patient's name and date of birth, to ensure the right person receives the medication.

B. The right MAR: While the Medication Administration Record (MAR) is essential for tracking medication administration, it is not classified as one of the six rights.

C. The right route: Administering medication via the appropriate route (e.g., oral, intravenous) is vital for the drug's effectiveness. Different routes can affect absorption and efficacy, making this a key component of safe medication administration.

D. The right expiration date: Although checking the expiration date is important for safety, it is not part of the core six rights of medication administration.

E. The right health care provider: While appropriate prescribing is important, this does not fall under the six rights of medication administration.

F. The right dose: Confirming the correct dose is essential to avoid potential toxicity or ineffective treatment. Dosage calculations must be precise, considering the patient's age, weight, and clinical condition.

G. The right documentation: Accurate documentation of medication administration is crucial for continuity of care. It helps ensure that all healthcare providers are informed of what medications have been given, thereby preventing duplicate doses or missed medications.

H. The right conversion factor: While conversions may be necessary for dosing, this is not considered one of the six rights.

I. The right medication: Verifying the correct medication is fundamental to patient safety. This involves checking the medication label against the MAR to prevent administering the wrong drug, which could have serious consequences.

J. The right time: Administering medications at the correct scheduled times is essential for maintaining therapeutic drug levels in the body. Timely administration helps ensure that the medication works effectively and enhances patient adherence to their treatment plan.